Dr. med. Dirk Manski

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Bladder Tamponade: Diagnosis and Treatment


Bladder tamponade is a bladder filled with blood clots due to hematuria with difficult voiding and risk of urinary retention.

fig. Intravenous urography of bladder tamponde: large round filling defect in the bladder
Intravenous urography of bladder tamponade: large round filling defect in the bladder. With kind permission, Prof. Dr. R. Harzmann, Augsburg.

Etiology of Bladder Tamponade:

Signs and symptoms:

LUTS, passage of blood clots via the urethra, pelvic pain, urinary retention. In the absence of therapy, bladder rupture with urine extravasation is possible.


fig. CT of an intraperitoneal bladder rupture injury
Ultrasound imaging of bladder tamponade (sagittal plane): round echogenic lesion in the full bladder.

Treatment of Bladder Tamponade

Acute and low-grade bladder tamponades can be removed with the help of catheters by aspiration with a bladder syringe (preferably via a rigid catheter 20–24 CH). Ensure sufficient analgesia for this painful procedure. After removing the tamponade, an irrigation catheter is inserted, and continuous irrigation is done depending on the intensity of the hematuria.

Pronounced bladder tamponades, especially with active bleeding of the lower urinary tract, necessitate treatment in general anesthesia: aspiration of the tamponade over the shaft of the resectoscope, followed by coagulation of the bleeding area. To treat significant upper urinary tract bleeding, see treatment of the underlying disease.

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  Deutsche Version: Harnblasentamponade